941-462-4807 meg@megyounglcsw.com

fail Most therapists worry that a client will commit suicide. Many therapists have had this happen to them already. When this happens, we second guess ourselves and our care of the client. Many therapists start wondering what they could have done different. What they didn’t see. What they did wrong. Whereas it is good to review the case and determine whether there was something missed, it is not helpful to dwell on it long afterward. But many of us do.
Unfortunately, when we struggle to move forward in our careers and lives after a client suicide, it affects our professional and personal lives. We bring the stress and feelings home. We notice changes in our relationships with our other clients as well as with our families and friends. We may even second guess what other people think about us.
The downsides to this include starting to feel like a failure, feeling burnt out, feeling incapable, feeling like a disappointment, or sometimes like a fraud. When these feelings start to surface, it is hard to think of much else. These feelings start to consume us (thank you Limbic System of the brain). When these feelings start to overwhelm us, we start to behave differently. Just like when you’re happy and sad you behave differently.
Not only does living life feeling like a failure and incapable affect our emotional wellbeing and our relationships, but it affects our bodies. The body and brain work together. When one isn’t working optimally, the part notices and joins in. Misery loves company? So when the brain says something is wrong, the body goes into sympathetic dominance causing all of the bodily functions that are not needed for immediate survival to shut down. Having this happen ongoing is a frequent cause of high blood pressure, ulcers, gastrointestinal distress, headaches, fatigue, and heart problems.
Judy had a client who seemed to be improving. The client seemed to be in a much better place and therapy seemed to be working well. Then Judy got the call. Her client had killed herself. All sorts of thoughts ran through her mind. She struggled to wrap her head around it. She felt scared. She went through her case notes over and over trying to figure out what she missed. She felt absolutely horrible. She couldn’t figure it out. But she must have missed something.
Unfortunately, as she looked and looked, she still did not find anything that gave her a clue as to this possibly happening. She felt like a failure. She must have missed it. She must not have asked the right questions. Or missed a signal from the client. Or…or…or… Unfortunately, all this did was make her feel worse about herself. Her feelings of being a failure increased with each passing day.
Eventually she wound up in a place where she was just not present for her clients. She just couldn’t do the job anymore. It was too stressful wondering if any of her other clients would kill themselves. Did they know she was the therapist for the person that just killed themselves? Was she actually helping people? She was spiraling down and struggling to keep afloat.
The truth is, what Judy was feeling was completely normal. We get into this field to help people. When someone kills themselves, we feel strongly about it. We were very invested in them and in their lives. It is completely normal to feel horrible, or even like a failure (although this isn’t what I want you to feel).
This is a very scary situation to have happen and it impacts many areas of your life. However, when we see others overcome something similar, it often inspires us to make the changes we need to achieve confidence in ourselves. When we take similar steps, it is entirely possible to bounce back and continue the wonderful work we do.
Before scheduling a session with me, Judy’s life was in shambles. She struggled to keep up with the daily grind of life at home and at work. She missed paying some bills (her mind was elsewhere and honestly forgot). She wasn’t paying attention to her health as much. She liked to be in bed and sleep away her stress. She ignored others when they told her she was just not acting like herself. Judy often found herself feeling depressed, hopeless, and like a failure.
Living this way impacted Judy’s ability to function at work and at home. Her career suffered for it, which increased her feelings of inadequacy. She “knew” at this point that the client’s suicide was not her fault. However, she still couldn’t get herself to believe deep down that she did all she could for this client…that she didn’t miss something.
Judy’s marriage was suffering also. Her husband didn’t know how to help her and was getting frustrated at her change in behavior and slipping up on small things such as paying bills. The more frustrated he got, the more fuel was added to her feelings of inadequacy and failure. Judy couldn’t bring herself to go out and do the things she enjoyed. What if someone asked her about it? What if someone asked her if she was ok? How should she even respond to that? Her friends and husband kept trying. They did not give up on her, but Judy continued to struggle with this.
Right before Judy scheduled a session, she had an ah-ha moment. Due to the support of loved ones, Judy finally realized she needed help. She was falling apart and was not able to pull herself together on her own. She knew it was ok to ask for help and made that first call. When she realized that she was so far gone and needed professional help to come back, she felt a mixture of emotions. She still felt like a failure…how did she let her life get this far down? But she also felt overwhelmed and scared. Would the therapist judge her? Judy knew she had to schedule the session despite all the mixed up feelings she was having. She had to schedule the session BECAUSE of all the mixed up feelings she was having.
When Judy presented to her first session, she expressed concern and fear. She wasn’t sure she wanted to share the exact trauma that precipitated this downfall. I did not push her to tell me, but instead explored with her where her feelings came from…when they actually started. Often an incident that has a huge impact like this has the roots of the feelings at a younger age. So we explored other times in Judy’s life that she felt like a failure. By the time Judy left that first session, she felt confident that she could come back and continue to work on her feelings and beliefs about herself and the world.
As we continued therapy, Judy realized that her feelings of inadequacy stemmed from childhood and we created a treatment plan to address those feelings. I still did not push her to tell me anything that she did not want to share, even from childhood, which increased her confidence in working through the feelings.
When Judy and I sat down to work together, she felt very broken. She wasn’t sure if I would understand or would be able to help her. She wasn’t even sure she wanted to share what happened. We worked together slowly to raise her confidence in the process and not scare her away.
We discussed the core beliefs that led to the feelings of inadequacy and feeling like a failure. We discussed where these core beliefs came from, why they are so hard to let go of, and why they create such an impact on situations that occur today. I explained how these core beliefs interact with the Limbic System of the brain and how that in turn brings the body into fight/flight. We clarified the impact fight/flight has on the body and brain, why it activates, and why it is so hard to turn off.
As Judy learned more about how the body and brain work together and why certain things happen in the brain, she started to feel more “normal.” She started to realize she was not a failure and that she was a competent therapist. We identified ways to measure improvement and Judy stated she would know things are getting better because she will not take naps on weekend days and will be getting out for a walk at least twice per week.
When I practice with clients like Judy, who have experienced something incredibly traumatic and have negative core beliefs about themselves surrounding the trauma, I like to use a model of therapy called EMDR (Eye Movement Desensitization and Reprocessing). EMDR is a research backed and evidenced based model that can help people make strong, intrusive memories just a regular memory without the intense impact. It does not make the memory go away, nor does it change anything factual (if you truly had fault in something, it would not make you think you did not). EMDR is an amazing technique which can help clients regain power and control over themselves and their minds by de-linking the memory with the Limbic System in the brain.
After just a few sessions of EMDR, it was obvious that Judy was starting to feel better. She came to session with more pep, she spoke of more positive things going on in her life, and she smiled more. Judy also noticed improvement in her sleep habits and eating patterns. She finally told me of her client’s suicide and stated that this was the first time she said it out loud without breaking down. She stated that she is going out with her friends more again and that her husband has stated that he sees an improvement in her.
Judy came to session one day and stated that she was ready to end therapy. She stated that she has increased her caseload again and is feeling confident in herself. She stated that her relationships are going well and her life/work balance has improved. We created a plan to address any further negative core beliefs that may pop up to nip their intrusion on her life. By our final session, Judy felt like her old self again.
Although you struggle with feelings of self-doubt, failure, and lack of confidence, you have the potential to regain your confidence and be the counselor you know you are. When something traumatic happens (or just life happens – we all know that working with people all day can become draining), it doesn’t have to mean the end of your career. You came to this field for a reason. Let’s make sure that passion stays alive.
Now that you’ve seen what is possible for Judy, let this stand as a beacon for you to know that it is possible for you to also feel more confident in yourself and let go of those feelings of being a failure. You have the opportunity to be the encouraged and excited therapist you were before the impact of your client’s lives got to you.
Achieving confidence may take time. There are many factors to consider when determining how long it will take before you feel better. However, when you take this journey one day at a time, gaining confidence can be empowering. You absolutely can get yourself back. Meg Young, LCSW specializes in our Critical Care Givers, including therapists just like you, move from internal turmoil to internal control thus gaining their lives and careers back. Call me today 941-462-4807 to schedule your appointment! You are worth it.